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What Does Blue Shield of California’s New Unbundled Pharmacy Model Mean to Employers?

Viewpoints from Craig Hasday Blue Shield of California’s recent decision to unbundle its pharmacy benefit program and work with multiple vendors – including Amazon and the Mark Cuban Cost Plus Drug Company – wiped out $20 billion in market capitalization of the owners of the three largest pharmacy benefit managers within hours of the announcement. … Continued

https://www.epicbrokers.com/insights/blue-shield-unbundled-pharmacy-model-and-employers/

Pharmacy Pricing Is a High-Cost Chess Game. You Need a Life Master on Your Side.

Viewpoints from Craig Hasday Affordability is the single biggest issue in healthcare. There is no greater challenge for plan sponsors than managing the cost of pharmacy benefits. For some groups, pharmacy costs exceed 30% of total cost accruals. Specialty pharmacy is growing faster than the rate of medical inflation, potentially representing 50% of this expense. … Continued

https://www.epicbrokers.com/insights/pharmacy-pricing-high-cost-chess-game/

Why You Need a Specialist in Pharmacy to Manage Healthcare Costs

Our association with Pharmacy Strategies Group (PSG) has made me even more acutely aware of the importance of proactive pharmacy consulting in managing overall healthcare costs. For years, I have been writing in the abstract that specialty pharmacy costs are the fastest-growing component of healthcare expenses. Now, I feel like I am “armed for bear” … Continued

https://www.epicbrokers.com/insights/why-you-need-a-specialist-in-pharmacy-to-manage-healthcare-costs/

Why You Need a Specialist to Control Pharmacy Spend

As pharmacy costs continue to escalate, payors are introducing new strategies to combat spiraling costs while balancing appropriate access. But costs continue to be shrouded in mystery with jockeying between the various intermediaries for a share of the profits. The rebate game has garnered focus as pharmacy benefit managers (PBMs) maximize rebate compensation (contributing to … Continued

https://www.epicbrokers.com/insights/you-need-a-specialist-to-control-pharmacy-spend/

Will Amazon Pharmacy Change Healthcare?

Viewpoints from Craig Hasday The market shuddered at the announcement of Haven Healthcare – the partnership between Amazon, JPMorgan Chase and Berkshire Hathaway. This powerful trio combined financial savvy with insurance and distribution expertise. Surely, they would meaningfully move the market. Well, so far – not so much. Healthcare indeed represents almost 20% of Gross … Continued

https://www.epicbrokers.com/insights/will-amazon-pharmacy-change-healthcare/

Managing Pharmacy Costs Is Key for Employers

Viewpoints from Briana Loff Every year, Express Scripts (ESI), one of the nation’s top leading pharmacy benefit managers (PBMs), releases its annual drug trend report. Their report for 2019 analyzed costs and spending for over 33.6 million members currently enrolled in one of their drug plans. Express Scripts noted this is the third year in … Continued

https://www.epicbrokers.com/insights/managing-pharmacy-costs-is-key-for-employers/

Put Pharmacy Costs Under the Microscope in 2020

In 2015, prescription drug spending in the United States was reported at $337 billion. It is projected that spending will reach $560 billion in 2020, a 66% increase over 5 years. Optum, the pharmacy benefit manager (PBM) subsidiary of UnitedHealthcare recently reported that there are over 150 drugs in the pipeline currently being evaluated by … Continued

https://www.epicbrokers.com/insights/put-pharmacy-costs-under-the-microscope-in-2020/

Understanding the Fiduciary Responsibility Employers Face for Their Benefit Plans

Viewpoints by Craig Hasday One of the most critical components of the Employee Retirement Income Security Act of 1974 (ERISA) is the fiduciary responsibility imposed on employers and administrators managing these types of plans. Employers should be concerned. ERISA requires employers to maintain oversight of vendors and monitor pharmacy and medical costs, and the penalties … Continued

https://www.epicbrokers.com/insights/employer-fiduciary-risk-assessment-checklist/

Fiduciary Rule Changes Require Better Plan Management

Viewpoints from Craig Hasday Employees pay greater than 20% of the cost of their employer-sponsored healthcare premiums. In addition to those premiums, the average American family spends more than $4,000 per year on their out-of-pocket medical costs. Healthcare costs, after a COVID-driven pause, are continuing to escalate and consumers are feeling the pain. Employee Retirement … Continued

https://www.epicbrokers.com/insights/fiduciary-rules-pharmacy-costs/

Large Claims Alarms Are Signaling Healthcare Cost Spikes

Viewpoints from Craig Hasday Regardless of your plan’s size or funding arrangement, prepare yourself. Large claims are coming. According to a QBE report, claims over $200,000 increased by 17% from 2020 to 2021. While it was harder to see through the crystal ball during the COVID-19 years, it is starting to get clearer again. This … Continued

https://www.epicbrokers.com/insights/large-claims-signaling-healthcare-cost-spikes/